CAJ | 학술논문

目的探讨新型甲型H1N1流感(简称甲型流感)危重病例肺部影像学的变化及其临床特点. 方法山西省太原市第四人民医院2009年10月20日至11月22日收治的10例重症甲型流感确诊患者,男6例,女4例,年龄5～41岁,平均19.3岁.采用常规技术检测血常规、血气指标、肝肾功能及心肌酶学变化,并行胸部X线及CT检查;给予奥司他韦、吸氧、呼吸支持、抗感染及对症支持等综合治疗. 结果患者均以发热、咳嗽、呼吸困难为主要症状,肺部病灶表现多种多样,表现为磨玻璃影及实变影、肺不张、液气胸及胸腔积液等征象,进展快,同时存在急性肺炎和急性间质性肺炎的影像学改变,10例中5例发展为急性肺损伤,3例发展为ARDS;奥司他韦、呼吸支持及抗感染治疗有效. 结论甲型流感危重病例的影像学表现为急性肺炎和急性间质性肺炎改变,临床表现为病情重、进展快,可发展为ARDS.
목적 탐토신형갑형H1N1류감(간칭갑형류감)위중병례폐부영상학적변화급기림상특점. 방법 산서성태원시제사인민의원2009년10월20일지11월22일수치적10례중증갑형류감학진환자,남6례,녀4례,년령5～41세,평균19.3세.채용상규기술검측혈상규、혈기지표、간신공능급심기매학변화,병행흉부X선급CT검사;급여오사타위、흡양、호흡지지、항감염급대증지지등종합치료. 결과 환자균이발열、해수、호흡곤난위주요증상,폐부병조표현다충다양,표현위마파리영급실변영、폐불장、액기흉급흉강적액등정상,진전쾌,동시존재급성폐염화급성간질성폐염적영상학개변,10례중5례발전위급성폐손상,3례발전위ARDS;오사타위、호흡지지급항감염치료유효. 결론 갑형류감위중병례적영상학표현위급성폐염화급성간질성폐염개변,림상표현위병정중、진전쾌,가발전위ARDS.
Objective To study the clinical features and the pulmonary imaging changes of severe cases of new influenza A(H1N1). Methods This study included 10 severe cases with new influenza A (H1N1)infection in the Forth People's Hospital of Taiyuan from 20 Oct. 2009 to 22 Nov 2009.Six patients were males and 4 were females,with an average age of 19.3 years(range 5-41 years).The laboratory study included blood routine.blood gas analysis,liver and renal function tests,myocardium enzymology,chest radiograph and CT. Results The prominent clinical features included fever.cough and dyspnea.The pulmonary imaging changes were varied,including ground-glass opacity,consolidation,atelectasis,fluid pneumothorax and pleural effusion,and manifestations of acute pneumonia and interstitial pneumonia simultaneously.Extensive pulmonary infiltration developed quickly,and acute lung injury(ALI)Occurred in 5 patients and acute respiratory distress syndrome(ARDS)in 3 cases.Oseltamivir,oxygen therapy and antibiotic therapy were effective for improvement of the disease and final recovery of all these patients. Conclusions The severe cases of new influenza A (H1N1) infection has imaging manifestations of acute pneumonia and interstitial pneumonia.The disease progresses quickly and may lead to ALI/ARDS.